Apr 25, 2008

Mobiles & Medicine - The Sum Of All Elements

Today, I continue my series of comparisons between the medical and the mobile fields. I had previously talked about the fact that not everything is under control in both worlds, and that no matter how perfect an object is built, something at some point can and will go wrong.

I just returned from a Medical Ethics exam today, and one of the questions asked was related to a statement made by Pope Benedict XVI about the biomedical sciences. The exam was in French, but basically what the Pope meant to say was that biomedical sciences should be used for the good of humanity, because if they didn't have the benefit of the human kind as a goal, they would be cold and heartless science. We were asked to reflect on this opinion as pharmacists, as well as give examples of how biomedical sciences can at some point hurt humanity or a human.

In my paper, starting my thinking process from the "cold and heartless science" affirmation, i set out to compare medicine with arithmetics. I didn't go into details there, but I will here. Our constant tendency, in the medical field is to take book sentences and research results wholeheartedly. When we are presented with "disease x" we always tend to give "cure a" because it's written somewhere, and we sure don't know better than those illustrate scientists. When we are presented with "disease y" we will give "cure b", for the same reason. The tricky part comes when we have "disease x + disease y" in the same person. What do we do? First, we try to find research about those 2 diseases occuring together, the reasons behind it, as well as that "written somewhere" treatment scheme. If this search result comes out blank, we're left to pray that we're going to make the right decision. Sometimes, we will give "cure a + cure b" after making sure that both medicines aren't incompatible ; other times we will give "cure a or cure b" if we know for a certain reason that curing one disease will help the other ; and some other times, we will go totally blunt and give "cure c" which is something that might work on both, not quite ideally, but it does.

See, medicine is a lot more complicated than simple math, two illnesses together can be equal to the sum of each one individually, but it can be more or less than that sum, it can also be an indication of a totally different illness. If I have chronic dyspnea, it might be asthma or COPD (chronic obstructive pulmonary disease). If I have oedema, it might be renal failure. If I have both, we could treat them separately but we should investigate an underlying heart failure that didn't manifest itself. This is explained by the complexity of the human body, that I wrote about in my first post of the series, but it can also be explained by another arithmetics comparison.

How do you define a Human Being? Is it a mix of flesh, bones, muscles, nerves, blood, liquids? No. We are more than the sum of all of our elements. Now we may not know exactly what is the other abstract entity that adds up to the body in the equation. Some will call it the soul, others the spirit, others what we refer to as the heart, others will also add society or religion and what it teaches us, others will say that unconscious acts has got a piece of the cake, too, and many many more. For what it's worth, I believe it's all of that and a little bit more too. The physical dimension of the human, which is the body, is just the smallest entity in the equation. We might be perfectly healthy, yet feel pain or sick ; we might also be deep down into some disease and yet feel perfectly fit. Why? Simply, because we're more than just organs!

Now let's go back to the mobile field. One thing we notice, that is too darn obvious, is that a mobile is not "alive". Does that mean that it misses that sum of abstract elements that we added to the body? Well, I've never seen a mobile move by itself, so there goes your answer. When something goes wrong in one piece of the equipment, it will show up, because there's nothing there governing the process and trying to conceal it. A whole mobile device is equal to the sum of its elements, and that's why it doesn't play on you those tricky games that the body does.

This is what seriously differentiates health sciences from engineering sciences: the predictability factor. When there's a problem in the fuse in some piece of electronics, you know that changing it will solve the problem, it's predictable. When there's a health problem in a patient, you might give the perfect cure, the one you have used for years to treat this same disease, yet a couple of patients will not respond or will respond in a different manner, it's unpredictable. This has been the aim of the whole genetics field so far, to find patterns that will help making health evolutions more predictable in humans. The "oh, you have gene X, then you are likely to have disease Y around age Z" as well as the "oh, you have gene A, then you will respond in manner B to treatment C" seem to be what we are looking for, making things as predictable with the human body as they are with any other piece of equipment we have. We will succeed in removing a lot of variables in the equation, but will we even be close to remove them all? No. Because we're more than the sum of our elements.

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